Provider Demographics
NPI:1548329899
Name:DOUGLAS COUNTY BOARD OF COMMISSIONER
Entity type:Organization
Organization Name:DOUGLAS COUNTY BOARD OF COMMISSIONER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MADAM CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:ROMONA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-942-8626
Mailing Address - Street 1:12501 VETERANS MEMORIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2056
Mailing Address - Country:US
Mailing Address - Phone:770-294-2786
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:12501 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2056
Practice Address - Country:US
Practice Address - Phone:777-942-8626
Practice Address - Fax:770-920-7346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOUGLAS COUNTY BOARD OF COMMISSIONER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-06
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00160927AMedicaid
GA85041759AAMedicare ID - Type Unspecified